Admissions: A Life in Brain Surgery - as seen on 'life-changing' BBC documentary Confessions of a Brain Surgeon

by Henry Marsh

The efficiency of the hospital was a perfect illustration of Dunbar’s number – that magic number of 150. The size of our brain, Robin Dunbar, an eminent evolutionary anthropologist at Oxford University, has argued (and the brain size of other primates), is determined by the size of our ‘natural’ social group, when humans and their brains evolved in small hunting and gathering groups. We have the largest brains among primates, and the largest social group. We can relate to about 150 people on an informal, personal basis, but beyond that leadership, impersonal rules and job descriptions become necessary.

All knowledge is provisional.

There was a famous experiment many years ago by the American neuroscientist Benjamin Libet – confirmed many times since – that showed that the conscious decision to move the hand is preceded by electrical activity in the hand area of the brain. Nobody has yet provided a satisfactory account of what this really means. It is as though the deciding self is no different from the sailor in the storm who is forced to steer his boat in the storm’s direction, but then claims to have chosen the direction himself. And yet to claim, as some do, that the conscious self is an illusion, that it is no more than running before the wind, or a consoling fairy story, somehow seems as implausible as maintaining that pain is an illusion, and not ‘really’ painful.

Psychologists talk of the ‘endowment effect’ – that we are more concerned about losing things than gaining them.